The essence of community hospitals

In our latest Viewpoint piece Dr Helen Tucker, Vice President of the Community Hospitals Association discusses the role of small hospitals in the NHS.

The statement from Simon Stevens about the role of small hospitals in the NHS is welcome, and unexpected.

Those communities who are actively campaigning to keep their valued local hospitals are stopped in their tracks. Can this be right – does the NHS have room now for community hospitals as part of its infrastructure? A clear message from the CEO of the NHS would suggest so.

The reason for establishing cottage hospitals originally is still pertinent – to create a clean and safe environment so that GPs, consultant specialists and nurses can work together in an integrated way to treat patients within their own communities. It is hard to imagine that within 30 years of the first cottage being converted to create a hospital setting, there were 240 new hospitals across England. This was an astounding development, possible only with public support and donations. This strength of support is still very tangible today through volunteering fundraising and promotion. It is certainly visible when hospitals are threatened and local people attend public meetings or march through the streets.

Local people clearly have confidence in their local hospital service, and when creating community capacity to enable more people to be treated outside of acute hospitals, this would seem to be a strong basis to build on. Rather than view cottage/community hospitals as out-dated in this modern high tech world, surely it is better to build on this strong tradition of care and view the trust that the service has earned over generations as a positive factor when designing community-based services. This is not just about sentimentality and the status of having a local hospital in your community. Studies have shown the rehabilitation outcomes for older people are positive cost effective appropriate and attract a high level of satisfaction. This is a significant service meeting local needs.

And yet their history is one of uncertainty and turbulence, with some hospitals under continual threat of closure or reduced services in the drive for centralisation and specialisation...